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1.
Arch Virol ; 168(11): 278, 2023 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-37864757

RESUMEN

Monkeypox virus is a member of the family Poxviridae, as are variola virus and vaccinia virus. It has a linear double-strand DNA genome approximately 197 kb long, containing ~190 non-overlapping ORFs. Comparison of members of the Central and West African clades shows the presence of unique genes that are associated with different disease presentations, depending on the strain. The last smallpox vaccination efforts ended in the mid-1980s, and there is concern about the recent spread of human monkeypox disease around the world. Almost 87,000 human monkeypox cases have been diagnosed in the world, of which more than 10,900 were in Brazil. The aim of this study was to evaluate the epidemiology and molecular evolution of hMpxV. From computational biology analysis of 640 hMpxV genomes from 1962 to 2022, synteny breaks and gene conservation were observed between Central and West clade genomes, and strains belonged with the 2022 outbreak assigned to the West African clade. Evidence was found for diversifying selective pressure at specific sites within protein coding sequences, acting on immunomodulatory processes. The existence of different sites under diversifying and purifying selection in paralog genes indicates adaptive mechanisms underlying the host-pathogen interaction of monkeypox virus in humans.


Asunto(s)
Mpox , Poxviridae , Humanos , Monkeypox virus/genética , Mpox/epidemiología , Poxviridae/genética , Genómica , Evolución Molecular
2.
Neurourol Urodyn ; 42(5): 1088-1100, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36971037

RESUMEN

INTRODUCTION: Age-related white matter hyperintensities (ARWMHs) on brain magnetic resonance imaging have been associated with lower urinary tract symptoms/dysfunction (LUTS/LUTD), namely overactive bladder (OAB) and detrusor overactivity. We aimed to systematically review existing data on the association between ARWMH and LUTS and which clinical tools have been used for this assessment. MATERIALS AND METHODS: We searched PubMed/MEDLINE, Cochrane Library, and clinicaltrials.gov (from 1980 to November 2021) and considered original studies reporting data on ARWMH and LUTS/LUTD in patients of both sexes aged 50 or above. The primary outcome was OAB. We calculated the unadjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for the outcomes of interest using random-effects models. RESULTS: Fourteen studies were included. LUTS assessment was heterogeneous and mainly based on the use of nonvalidated questionnaires. Urodynamics assessment was reported in five studies. ARWMHs were graded using visual scales in eight studies. Patients with moderate-to-severe ARWMHs were more likely to present with OAB and urgency urinary incontinence (UUI; OR = 1.61; 95% CI: 1.05-2.49, p = 0.03), I2 = 21.3%) when compared to patients with similar age and absent or mild ARWMH. DISCUSSION AND CONCLUSIONS: High-quality data on the association between ARWMH and OAB is scarce. Patients with moderate to severe ARWMH showed higher levels of OAB symptoms, including UUI, when compared to patients with absent or mild ARWMH. The use of standardized tools to assess both ARWMH and OAB in these patients should be encouraged in future research.


Asunto(s)
Síntomas del Sistema Urinario Inferior , Vejiga Urinaria Hiperactiva , Incontinencia Urinaria , Sustancia Blanca , Masculino , Femenino , Humanos , Sustancia Blanca/diagnóstico por imagen , Incontinencia Urinaria/complicaciones , Síntomas del Sistema Urinario Inferior/diagnóstico , Encuestas y Cuestionarios
3.
Environ Res ; 234: 116512, 2023 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-37394164

RESUMEN

Anthropogenic activities are regarded as point sources of pollution entering freshwater bodies worldwide. With over 350,000 chemicals used in manufacturing, wastewater treatment and industrial effluents are comprised of complex mixtures of organic and inorganic pollutants of known and unknown origins. Consequently, their combined toxicity and mode of action are not well understood in aquatic organisms such as Daphnia magna. In this study, effluent samples from wastewater treatment and industrial sectors were used to examine molecular-level perturbations to the polar metabolic profile of D. magna. To determine if the industrial sector and/or the effluent chemistries played a role in the observed biochemical responses, Daphnia were acutely (48 h) exposed to undiluted (100%) and diluted (10, 25, and 50%) effluent samples. Endogenous metabolites were extracted from single daphnids and analyzed using targeted mass spectrometry-based metabolomics. The metabolic profile of Daphnia exposed to effluent samples resulted in significant separation compared to the unexposed controls. Linear regression analysis determined that no single pollutant detected in the effluents was significantly correlated with the responses of metabolites. Significant perturbations were uncovered across many classes of metabolites (amino acids, nucleosides, nucleotides, polyamines, and their derivatives) which serve as intermediates in keystone biochemical processes. The combined metabolic responses are consistent with oxidative stress, disruptions to energy metabolism, and protein dysregulation which were identified through biochemical pathway analysis. These results provide insight into the molecular processes driving stress responses in D. magna. Overall, we determined that the metabolic profile of Daphnia could not be predicted by the chemical composition of environmentally relevant mixtures. The findings of this study demonstrate the advantage of metabolomics in conjunction with chemical analyses to assess the interactions of industrial effluents. This work further demonstrates the ability of environmental metabolomics to characterize molecular-level perturbations in aquatic organisms exposed to complex chemical mixtures directly.


Asunto(s)
Aminoácidos , Contaminantes Químicos del Agua , Animales , Aminoácidos/metabolismo , Daphnia , Metabolómica/métodos , Metaboloma , Estrés Oxidativo , Organismos Acuáticos , Contaminantes Químicos del Agua/análisis
4.
Epidemiol Infect ; 150: e199, 2022 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-36382397

RESUMEN

From 2016-2019, dry bulb onions were the suspected cause of three multistate outbreaks in the United States. We investigated a large multistate outbreak of Salmonella Newport infections that caused illnesses in both the United States and Canada in 2020. Epidemiologic, laboratory and traceback investigations were conducted to determine the source of the infections, and data were shared among U.S. and Canadian public health officials. We identified 1127 U.S. illnesses from 48 states with illness onset dates ranging from 19 June to 11 September 2020. Sixty-six per cent of ill people reported consuming red onions in the week before illness onset. Thirty-five illness sub-clusters were identified during the investigation and seventy-four per cent of sub-clusters served red onions to customers during the exposure period. Traceback for the source of onions in illness sub-clusters identified a common onion grower in Bakersfield, CA as the source of red onions, and onions were recalled at this time. Although other strains of Salmonella Newport were identified in environmental samples collected at the Bakersfield, CA grower, extensive environmental and product testing did not yield the outbreak strain. This was the third largest U.S. foodborne Salmonella outbreak in the last 30 years. It is the first U.S. multistate outbreak with a confirmed link to dry bulb onions, and it was nearly 10-fold larger than prior outbreaks with a suspected link to onions. This outbreak is notable for its size and scope, as well as the international data sharing that led to implication of red onions as the primary cause of the outbreak. Although an environmental assessment at the grower identified several factors that likely contributed to the outbreak, no main reason was identified. The expedient identification of the outbreak vehicle and response of multiple public health agencies allowed for recall and removal of product from the marketplace, and rapid messaging to both the public and industry on actions to protect consumers; these features contributed to a decrease in cases and expeditious conclusion of the outbreak.


Asunto(s)
Contaminación de Alimentos , Cebollas , Infecciones por Salmonella , Salmonella enterica , Humanos , Canadá/epidemiología , Brotes de Enfermedades , Cebollas/microbiología , Salmonella , Infecciones por Salmonella/epidemiología , Estados Unidos/epidemiología
5.
Int Urogynecol J ; 33(11): 3061-3066, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35013758

RESUMEN

INTRODUCTION AND HYPOTHESIS: The International Consultation on Incontinence Questionnaire (ICIQ) Bladder Diary (BD) is a standardized and validated diary, developed in the English language, designed to assess lower urinary tract symptoms (LUTS) in men and women. This study reports the translation, cross-cultural adaptation and validation process of this diary to the Portuguese language. METHODS: After translation and back-translation of the ICIQ-BD to Portuguese, 140 urologic patients were asked to fill in this 3-day diary as well as the Overactive Bladder questionnaire Short Form (OABqSF) and a questionnaire evaluating the difficulties in filling out the ICIQ-BD. A subset of 60 patients filled out a second diary with/without LUTS treatment in between (30 patients in each group). In addition, content validity, internal consistency, criterion and construct validity were tested. RESULTS: The Portuguese version of the ICIQ-BD showed adequate internal consistency (Cronbach's alpha of 0.78), and patients reported few difficulties in filling out this tool, answering most commonly 1 on a 1-6 scale of difficulty. Excellent test-retest reliability and responsiveness of the diary were observed when comparing the first diary to a second completed 2-6 weeks later. Criterion validity was also confirmed, given the good correlation with the OABqSF (Pearson's 0.386-0.447). Finally, construct validity was established through statistically significant concordance between data obtained in the BD with generally accepted theories. CONCLUSION: The present version of the ICIQ-BD is the first bladder diary successfully validated in the Portuguese language. It is a suitable and standardized tool for scientific research and diagnostic assessment of LUTS in adult men and women.


Asunto(s)
Síntomas del Sistema Urinario Inferior , Vejiga Urinaria Hiperactiva , Incontinencia Urinaria , Adulto , Femenino , Humanos , Lenguaje , Síntomas del Sistema Urinario Inferior/diagnóstico , Masculino , Portugal , Calidad de Vida , Derivación y Consulta , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Vejiga Urinaria , Vejiga Urinaria Hiperactiva/diagnóstico , Incontinencia Urinaria/diagnóstico
6.
Appetite ; 174: 106012, 2022 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-35367482

RESUMEN

Estrogens reduce 0.3 M NaCl intake and palatability in a widely used model of essential hypertension, the spontaneously hypertensive rats (SHRs). Here we investigated whether the inhibitory effects of ß-estradiol (E2, 10 µg/kg b.w. subcutaneously for 8 days) on water deprived partially-rehydrated (WD-PR) ovariectomized (OVX) adult female SHRs (fSHRs, n = 4-10/group) are related to interferences on brain angiotensin II AT1 receptors (AT1r). After WD-PR, E2 reduced 0.3 M NaCl intake (1.3 ± 0.6, vs. vehicle: 3.5 ± 1.2 ml/30 min), the number of hedonic responses to intraoral NaCl infusion (57 ± 11, vs. vehicle: 176 ± 32/min), and the relative angiotensin AT1r (Agtr1a) mRNA expression in the hypothalamus. Losartan (AT1r antagonist, 100 µg) intracerebroventricularly in OVX fSHRs treated with vehicle subcutaneously abolished 0.3 M NaCl intake (0.1 ± 0.1 ml/30 min) and only transiently reduced hedonic responses to intraoral NaCl. Losartan combined with E2 decreased the number of hedonic and increased the number of aversive responses to intraoral NaCl and abolished 0.3 M NaCl intake. E2 also reduced the pressor and dipsogenic responses to intracerebroventricular angiotensin II. The results suggest that AT1r activation increases palatability and induces NaCl intake in WD-PR fSHRs. E2 reduced hypothalamic Agtr1a mRNA expression, which may account for the effects of E2 on NaCl intake and palatability and intracerebroventricular angiotensin II-induced pressor and dipsogenic responses in OVX fSHRs. Future studies considering natural fluctuations in estrogen secretion might help to determine the degree of such interference in brain neuronal activity.


Asunto(s)
Angiotensina II , Losartán , Angiotensina II/farmacología , Animales , Estradiol/farmacología , Femenino , Humanos , Losartán/farmacología , ARN Mensajero , Ratas , Ratas Endogámicas SHR , Receptor de Angiotensina Tipo 1/genética , Cloruro de Sodio
7.
Clin Pract Epidemiol Ment Health ; 18: e174501792201140, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-37274848

RESUMEN

Background: Cocaine/crack use affects immune system molecules and development of mental disorders has been identified. Objective: To investigate the relationship of polymorphisms in the TNFA (-308G/A), IL-10 (-819C/T) and ENOS (-786T/C) genes with mental disorders in cocaine and crack users. Methods: A case-control study was carried out, which included 107 cocaine and crack users and 115 controls who never used healthy cocaine and crack. The SNPs in the TNFA (-308G/A), IL-10 (-819C/T) and ENOS (-786T/C) genes were genotyped by real time PCR. Results: As for the individuals included in this study, the average age of 31.4 years (± 8.59). We identified that the G/A genotype to TNFA (-308) (OR = 0.24; p = 0.03) and the A allele (OR = 0.30; p = 0.03) were associated with reduced risk for dysthymic disorder. The T allele of the IL-10 (-819) polymorphism was associated with decreased risk of developing panic disorder (OR = 0.44; p = 0.01), while the C allele was correlated with an increased risk for alcohol dependence (OR = 1.97; p = 0.04), alcohol abuse (OR = 1.81; p = 0.04) and psychotic syndrome (OR = 2.23; p = 0.01). C/C genotype was correlated with increased chances of developing current psychotic syndrome (OR = 4.23; p = 0.01). Conclusion: Our results suggest that genetic polymorphisms promote susceptibility or promote protection for clinical phenotypes of psychiatric comorbidities in cocaine and crack users and be considered as good prognostic markers.

8.
Neurobiol Dis ; 152: 105287, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33549721

RESUMEN

Finely-tuned gamma (FTG) oscillations can be recorded from cortex or the subthalamic nucleus (STN) in patients with Parkinson's disease (PD) on dopaminergic medication, and have been associated with dyskinesias. When recorded during deep brain stimulation (DBS) on medication the FTG is entrained to half the stimulation frequency. We investigated whether these characteristics are shared off medication by recording local field potentials (LFP) from the STN from externalised DBS leads in 14 PD patients after overnight withdrawal of medication. FTG was induced de-novo by DBS in the absence of dyskinesias in a third of our cohort. The FTG could outlast stimulation or arise only after DBS ceased. FTG frequencies decreased during and across consecutive DBS blocks, but did not shift with changing stimulation frequency off medication. Together with the sustained after-effects this argues against simple entrainment by DBS in the off medication state. We also found significant coherence between STN-LFP and electroencephalogram (EEG) signals at FTG frequencies. We conclude that FTG is a network phenomenon that behaves differently in the off medication state, when it is neither associated with dyskinesias nor susceptible to entrainment.


Asunto(s)
Estimulación Encefálica Profunda/métodos , Ritmo Gamma/fisiología , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Núcleo Subtalámico/fisiopatología , Anciano , Antiparkinsonianos , Femenino , Humanos , Levodopa , Masculino , Persona de Mediana Edad
9.
Horm Behav ; 130: 104952, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33647281

RESUMEN

Spontaneously hypertensive rats (SHRs) ingest more NaCl than normotensive strains. Here we investigated NaCl intake and taste reactivity in adult male SHRs and normotensive Holtzman rats treated or not with AT1 receptor antagonist centrally in euhydrated condition and after fluid depletion. Taste reactivity was measured by the number of orofacial expressions to intra-oral infusions of 0.3 M NaCl. In euhydrated condition, intra-oral infusions of 0.3 M NaCl produced greater number of hedonic responses in SHRs than in normotensive rats, without differences in the number of aversive responses. Compared to euhydrated condition, the treatment with the diuretic furosemide + low dose of captopril (angiotensin converting enzyme blocker) increased the number of hedonic and reduced the number of aversive responses to intra-oral NaCl in normotensive rats, without changing the number of hedonic or aversive responses in SHRs. Losartan (AT1 receptor antagonist, 100 ng/1 µl) injected intracerebroventricularly in SHRs abolished 0.3 M NaCl intake induced by water deprivation + partial rehydration, whereas only transiently (first 30 min of the 60 min test) reduced hedonic responses, without changes in aversive responses to intra-oral NaCl. Losartan intracerebroventricularly also only transiently (first 30 min) reduced the number of hedonic responses to intra-oral NaCl in euhydrated SHRs. The results suggest that NaCl palatability is increased and independent from body fluid balance in SHRs. The results also suggest that central AT1 receptors are part of the mechanisms activated to increase NaCl intake and palatability in SHRs. A partial dissociation between NaCl intake and palatability in SHRs is also suggested.


Asunto(s)
Captopril , Sodio , Animales , Captopril/farmacología , Furosemida/farmacología , Losartán/farmacología , Masculino , Ratas , Ratas Endogámicas SHR
10.
Immunol Invest ; 50(5): 492-526, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32602796

RESUMEN

Objectives: This study investigated the relationship between single-nucleotide polymorphisms (SNPs) in cytokine genes and the susceptibility to Squamous Intraepithelial Lesions (SIL), cervical cancer and HPV infection through a systematic review with meta-analysis. To verify the effect of SNPs, we also analyzed the transcription factor binding affinity using bioinformatics tools.Methods: Seven electronic databases (MEDLINE, Scielo, BIREME, PubMed, Scopus, Web of Science and Science Direct) were searched for case-control studies.Results: A total of 35 relevant case-control studies were meta-analyzed, including 7 cytokine genes and 15 SNPs. SNPs in IL-17A (rs2275913, rs3748067); IL-17 F (rs763780); IL-12A (rs568408); IL-12B (rs3212227); TNFA (rs1800629, rs361525); IL-1B (rs16944); IL-6 (rs1800795); IL-10 (rs1800896) genes were associated with increased risk for cervical cancer. No association was observed between meta-analyzed polymorphisms and SIL. Additional bioinformatics analysis suggested a possible transcriptional regulation pathway of the TNFA and IL-10 genes through the MZF1 (TNFA -308 G > A and IL-10 - 1082A>G) and ZNF263 (TNFA -238 G > A) transcription factors binding.Conclusion: Overall, 10 SNPs in cytokine genes were associated with increased risk for cervical cancer. Therefore, in our meta-analysis, these SNPs demonstrated to be potential biomarkers for predicting or identifying cases of high risk for SIL and cervical cancer.


Asunto(s)
Alphapapillomavirus/fisiología , Citocinas/genética , Infecciones por Papillomavirus/genética , Lesiones Precancerosas/genética , Lesiones Intraepiteliales Escamosas de Cuello Uterino/genética , Neoplasias del Cuello Uterino/genética , Biología Computacional , Femenino , Predisposición Genética a la Enfermedad , Humanos , Infecciones por Papillomavirus/inmunología , Polimorfismo de Nucleótido Simple , Riesgo , Lesiones Intraepiteliales Escamosas de Cuello Uterino/inmunología , Neoplasias del Cuello Uterino/inmunología
11.
Appetite ; 158: 105037, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33186624

RESUMEN

The renin-angiotensin system (RAS) controls hypertonic NaCl intake driven by sodium appetite. Here we investigated whether the antagonism of RAS interferes with hedonic and aversive orofacial motor responses, or palatability, to intraoral infusion of 0.3 M NaCl (hNaCl). Adult rats were depleted of sodium by combined sc injection of furosemide and 24 h removal of ambient sodium. In experiment 1, losartan (AT1 angiotensin II receptor antagonist, intracerebroventricular, 200 µg/µl), produced a three-fold increase in aversive orofacial motor responses to hNaCl. Losartan also suppressed hNaCl intake recorded immediately thereafter. In experiment 2, each animal had repeated recordings of hNaCl intake and orofacial responses to hNaCl distributed for 180 min. Paired recordings of intake and orofacial responses occurred within five successive blocks after the recordings of only orofacial responses when the animals were still sodium deplete (block zero). Captopril (angiotensin converting enzyme blocker, intraperitoneal, 30 mg/kg) inhibited by 75% the hedonic orofacial responses to hNaCl in blocks zero and 1. The hedonic responses to captopril remained the same throughout blocks, but became similar to vehicle from blocks 2 to 5. There was no difference in aversive responses to 0.3 M NaCl between captopril and vehicle. Captopril produced a 70-100% inhibition of hNaCl intake in blocks 1 to 5. The results suggest that angiotensin II acts in the brain increasing the palatability of hypertonic sodium during the consummatory phase of sodium appetite.


Asunto(s)
Sistema Renina-Angiotensina , Sodio , Animales , Apetito , Captopril/farmacología , Losartán/farmacología , Ratas , Cloruro de Sodio
12.
Public Health ; 190: 123-131, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33453688

RESUMEN

OBJECTIVES: Epidemiological studies indicate an association between vitamin D deficiency and obesity. However, there is no consistent evidence of the direction or causal relationship between these conditions. Thus, we analysed the longitudinal relationship between vitamin D deficiency and obesity/adiposity in different age groups. STUDY DESIGN: This study was a systematic review with PROSPERO registry (CRD42016047523). METHODS: Electronic searches were undertaken in Lilacs, Medline, Science Direct, Scopus and Web of Science databases until April 2020. For each study, we collected the frequency of vitamin D deficiency and obesity. RESULTS: In total, 5071 articles were identified and 8 were ultimately included in this systematic review. Five cohort studies involved adults, two of which recorded a positive association between vitamin D deficiency and obesity. The other three studies found a borderline or null association between vitamin D deficiency and obesity. Three studies investigated the elderly population; two of these recorded an association between vitamin D and greater adiposity, and one study recorded that 25-hydroxyvitamin D levels ≥30 ng/ml were associated with less weight gain in the follow-up. CONCLUSIONS: This review reports that the majority of studies included show that vitamin D deficiency can contribute to the occurrence of obesity in adults and the elderly. It is recommended that prospective studies are conducted, with varying age groups and weather conditions, designed to test the longitudinal relationship between vitamin D deficiency and obesity outcomes.


Asunto(s)
Obesidad/etiología , Deficiencia de Vitamina D/complicaciones , Vitamina D/análogos & derivados , Vitamina D/administración & dosificación , Vitaminas/administración & dosificación , Adiposidad , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Masculino , Vitamina D/efectos adversos
13.
Neurobiol Dis ; 143: 105019, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32681881

RESUMEN

Local field potentials (LFPs) may afford insight into the mechanisms of action of deep brain stimulation (DBS) and potential feedback signals for adaptive DBS. In Parkinson's disease (PD) DBS of the subthalamic nucleus (STN) suppresses spontaneous activity in the beta band and drives evoked resonant neural activity (ERNA). Here, we investigate how STN LFP activities change over time following the onset and offset of DBS. To this end we recorded LFPs from the STN in 14 PD patients during long (mean: 181.2 s) and short (14.2 s) blocks of continuous stimulation at 130 Hz. LFP activities were evaluated in the temporal and spectral domains. During long stimulation blocks, the frequency and amplitude of the ERNA decreased before reaching a steady state after ~70 s. Maximal ERNA amplitudes diminished over repeated stimulation blocks. Upon DBS cessation, the ERNA was revealed as an under-damped oscillation, and was more marked and lasted longer after short duration stimulation blocks. In contrast, activity in the beta band suppressed within 0.5 s of continuous DBS onset and drifted less over time. Spontaneous activity was also suppressed in the low gamma band, suggesting that the effects of high frequency stimulation on spontaneous oscillations may not be selective for pathological beta activity. High frequency oscillations were present in only six STN recordings before stimulation onset and their frequency was depressed by stimulation. The different dynamics of the ERNA and beta activity with stimulation imply different DBS mechanisms and may impact how these activities may be used in adaptive feedback.


Asunto(s)
Estimulación Encefálica Profunda/métodos , Potenciales Evocados/fisiología , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Núcleo Subtalámico/fisiopatología , Anciano , Ritmo beta/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
14.
Eur J Neurol ; 27(12): 2422-2429, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32702196

RESUMEN

BACKGROUND AND PURPOSE: Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign. METHODS: We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis. RESULTS: Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms. CONCLUSION: Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.


Asunto(s)
Enfermedad de Parkinson , Antiparkinsonianos/uso terapéutico , Expresión Facial , Humanos , Hipocinesia , Levodopa/uso terapéutico , Pruebas de Estado Mental y Demencia , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/tratamiento farmacológico , Calidad de Vida
15.
J Surg Oncol ; 121(5): 730-742, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31845348

RESUMEN

BACKGROUND: Approximately 70% of cancer-related deaths occur in low- and middle-income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines. OBJECTIVES: The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers. METHODS: The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations. RESULTS: For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives. CONCLUSIONS: It is possible to provide adequate treatment for most EC patients in resource-limited areas, but the first option should be referral to specialized centers with more resources.


Asunto(s)
Países en Desarrollo , Neoplasias Endometriales/cirugía , Accesibilidad a los Servicios de Salud , Brasil , Neoplasias Colorrectales Hereditarias sin Poliposis/diagnóstico , Continuidad de la Atención al Paciente , Diagnóstico por Imagen , Neoplasias Endometriales/patología , Femenino , Preservación de la Fertilidad , Humanos , Histerectomía , Escisión del Ganglio Linfático , Recurrencia Local de Neoplasia/terapia , Estadificación de Neoplasias , Neoplasias Peritoneales/secundario , Neoplasias Peritoneales/terapia , Examen Físico , Derivación y Consulta , Biopsia del Ganglio Linfático Centinela , Sociedades Médicas
16.
Neurourol Urodyn ; 39(8): 2471-2479, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32956506

RESUMEN

AIMS: Local anesthesia protocols for intradetrusor onabotulinum toxin A (BoNTA) injection lack standardization. We aimed to determine if an alkalinized lidocaine solution is more effective than lidocaine only. METHODS: Patients of both genders aged 18 or above enlisted for intradetrusor BoNTA injection (idiopathic, neurogenic, and bladder pain syndrome) were included in a double-blinded randomized controlled trial after obtaining their informed consent. All participants filled a bladder diary and a urine culture was performed. Subjects were randomized 1:1 to Protocol A (20 ml 2% lidocaine + 10 ml 8.4% sodium bicarbonate) or Protocol B (20 ml 2% lidocaine + 10 ml 0.9% saline solution). A Numeric Rating Scale (0-10) was used to assess the level of pain immediately after the procedure (primary endpoint). Secondary endpoints included pain after 1 h, urinary tract infection, acute urinary retention, and hematuria related to the procedure. RESULTS: A total of 116 patients were randomized. Baseline characteristics (age, sex, indication, and bladder diary parameters) of patients in Group A and B were similar. Pain scores at the end of the procedure were significantly lower with the alkalinized solution (Protocol A and B, respectively, 2.37 ± 0.31 vs. 4.44 ± 0.36, p < .01). No differences were observed 1 h after treatment (Protocol A and B, respectively, 0.54 ± 0.17 vs. 0.69 ± 0.19, p = .487). The only adverse event reported was mild-to-moderate self-limited hematuria in 15.4% of patients. CONCLUSIONS: The use of an alkalinized lidocaine solution has proven to be significantly superior to lidocaine only as local anesthesia before intradetrusor BoNTA injection, suggesting that this may be considered a first-line option.


Asunto(s)
Anestésicos Locales/administración & dosificación , Toxinas Botulínicas Tipo A/administración & dosificación , Lidocaína/administración & dosificación , Dolor/tratamiento farmacológico , Vejiga Urinaria Neurogénica/tratamiento farmacológico , Agentes Urológicos/administración & dosificación , Administración Intravesical , Adulto , Anciano , Anciano de 80 o más Años , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor
17.
Neurourol Urodyn ; 39(8): 2535-2543, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32754994

RESUMEN

AIM: Lower urinary tract symptoms (LUTS) are a common urological referral, which sometimes can have a neurological basis in a patient with no formally diagnosed neurological disease ("occult neurology"). Early identification and specialist input is needed to avoid bad LUTS outcomes, and to initiate suitable neurological management. METHODS: The International Continence Society established a neurological working group to consider: Which neurological conditions may include LUTS as an early feature? What diagnostic evaluations should be undertaken in the LUTS clinic? A shortlist of conditions was drawn up by expert consensus and discussed at the annual congress of the International Neurourology Society. A multidisciplinary working group then generated recommendations for identifying clinical features and management. RESULTS: The relevant conditions are multiple sclerosis, multiple system atrophy, normal pressure hydrocephalus, early dementia, Parkinsonian syndromes (including early Parkinson's Disease and Multiple System Atrophy) and spinal cord disorders (including spina bifida occulta with tethered cord, and spinal stenosis). In LUTS clinics, the need is to identify additional atypical features; new onset severe LUTS (excluding infection), unusual aspects (eg, enuresis without chronic retention) or "suspicious" symptoms (eg, numbness, weakness, speech disturbance, gait disturbance, memory loss/cognitive impairment, and autonomic symptoms). Where occult neurology is suspected, healthcare professionals need to undertake early appropriate referral; central nervous system imaging booked from LUTS clinic is not recommended. CONCLUSIONS: Occult neurology is an uncommon underlying cause of LUTS, but it is essential to intervene promptly if suspected, and to establish suitable management pathways.


Asunto(s)
Síntomas del Sistema Urinario Inferior/diagnóstico , Enfermedades del Sistema Nervioso/diagnóstico , Factores de Edad , Consenso , Técnicas de Diagnóstico Urológico , Femenino , Humanos , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Enfermedades del Sistema Nervioso/complicaciones
18.
Appl Opt ; 59(8): 2530-2540, 2020 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-32225789

RESUMEN

LIDAR sensors are one of the key enabling technologies for the wide acceptance of autonomous driving implementations. Target identification is a requisite in image processing, informing decision making in complex scenarios. The polarization from the backscattered signal provides an unambiguous signature for common metallic car paints and can serve as one-point measurement for target classification. This provides additional redundant information for sensor fusion and greatly alleviates hardware requirements for intensive morphological image processing. Industry decision makers should consider polarization-coded LIDAR implementations. Governmental policy makers should consider maximizing the potential for polarization-coded material classification by enforcing appropriate regulatory legislation. Both initiatives will contribute to faster (safer, cheaper, and more widely available) advanced driver-assistance systems and autonomous functions. Polarization-coded material classification in automotive applications stems from the characteristic signature of the source of LIDAR backscattering: specular components preserve the degree of polarization while diffuse contributions are predominantly depolarizing.

19.
J Helminthol ; 94: e202, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33059788

RESUMEN

Lungworms are a common finding in seals and fur seals around the world. However, from existing records, the biogeographical distribution of filaroid helminths appears to be restricted, and these parasites are endemic in only certain areas and species, mainly in the Northern Hemisphere. The occurrence of infection in pinniped species in the Southern Hemisphere is scarce. The objective of this work is to verify the prevalence of lungworms in Arctocephalus australis in waters off the southern coast of Brazil. Twenty subadult specimens of A. australis found recently dead on the southern coast of Brazil were necropsied and their lungs were examined. Parasitic cysts were found in only one specimen (prevalence of 5%). The helminths were morphologically identified as Parafilaroides normani (Metastrongyloidea: Filaroididae). This helminth species has been reported in pinnipeds from Australia, New Zealand and South Africa. This is the first record of P. normani in A. australis and for the western South Atlantic, providing additional data regarding the biogeographic distribution of the parasite.


Asunto(s)
Distribución Animal , Filariasis/epidemiología , Filariasis/veterinaria , Filarioidea/anatomía & histología , Animales , Australia , Brasil/epidemiología , Femenino , Filarioidea/aislamiento & purificación , Filarioidea/fisiología , Lobos Marinos/parasitología , Geografía , Masculino , Nueva Zelanda , Filogenia , Prevalencia , Sudáfrica
20.
J Urol ; 212(2): 361, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38768170
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